Provider Demographics
NPI:1811197940
Name:HSIN, PETER TED (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:TED
Last Name:HSIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2437 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2434
Mailing Address - Country:US
Mailing Address - Phone:312-804-8489
Mailing Address - Fax:847-864-4744
Practice Address - Street 1:708 CHURCH ST
Practice Address - Street 2:#216
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3875
Practice Address - Country:US
Practice Address - Phone:312-804-8489
Practice Address - Fax:847-864-4744
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry